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Groborz O, Poláková L, Kolouchová K, Švec P, Loukotová L, Miriyala VM, Francová P, Kučka J, Krijt J, Páral P, Báječný M, Heizer T, Pohl R, Dunlop D, Czernek J, Šefc L, Beneš J, Štěpánek P, Hobza P, Hrubý M. Chelating Polymers for Hereditary Hemochromatosis Treatment. Macromol Biosci 2020; 20:e2000254. [PMID: 32954629 DOI: 10.1002/mabi.202000254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/27/2020] [Indexed: 12/17/2022]
Abstract
Hemochromatosis (iron overload) encompasses a group of diseases that are characterized by a toxic hyperaccumulation of iron in parenchymal organs. Currently, only few treatments for this disease have been approved; however, all these treatments possess severe side effects. In this study, a paradigm for hemochromatosis maintenance/preventive therapy is investigated: polymers with negligible systemic biological availability form stable complexes with iron ions in the gastrointestinal tract, which reduces the biological availability of iron. Macroporous polymer beads are synthesized with three different iron-chelating moieties (benzene-1,2-diol, benzene-1,2,3-triol, and 1,10-phenanthroline). The polymers rapidly chelate iron ions from aqueous solutions in vitro in the course of minutes, and are noncytotoxic and nonprooxidant. Moreover, the in vivo biodistribution and pharmacokinetics show a negligible uptake from the gastrointestinal tract (using 125 I-labeled polymer and single photon emission computed tomography/computed tomography), which generally prevents them from having systemic side effects. The therapeutic efficacy of the prepared polymers is successfully tested in vivo, and exhibits a significant inhibition of iron uptake from the gastrointestinal tract without any noticeable signs of toxicity. Furthermore, an in silico method is developed for the prediction of chelator selectivity. Therefore, this paradigm can be applied to the next-generation maintenance/preventive treatment for hemochromatosis and/or other diseases of similar pathophysiology.
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Affiliation(s)
- Ondřej Groborz
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic.,Department of Organic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43, Prague 2, Czech Republic.,Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovská 1, 120 00, Prague 2, Czech Republic
| | - Lenka Poláková
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic
| | - Kristýna Kolouchová
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic.,Department of Physical Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43, Prague 2, Czech Republic
| | - Pavel Švec
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic.,Department of Physical Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 43, Prague 2, Czech Republic
| | - Lenka Loukotová
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic
| | - Vijay Madhav Miriyala
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Flemingovo náměstí 542/2, 162 06, Prague 6, Czech Republic
| | - Pavla Francová
- Center for Advanced Preclinical Imaging (CAPI), First Faculty of Medicine, Charles University, Salmovská 3, 120 00, Prague 2, Czech Republic
| | - Jan Kučka
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic
| | - Jan Krijt
- Institute of Pathophysiology, First Faculty of Medicine, Charles University, U Nemocnice 5, 128 53, Prague 2, Czech Republic
| | - Petr Páral
- Center for Advanced Preclinical Imaging (CAPI), First Faculty of Medicine, Charles University, Salmovská 3, 120 00, Prague 2, Czech Republic
| | - Martin Báječný
- Center for Advanced Preclinical Imaging (CAPI), First Faculty of Medicine, Charles University, Salmovská 3, 120 00, Prague 2, Czech Republic
| | - Tomáš Heizer
- Center for Advanced Preclinical Imaging (CAPI), First Faculty of Medicine, Charles University, Salmovská 3, 120 00, Prague 2, Czech Republic
| | - Radek Pohl
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Flemingovo náměstí 542/2, 162 06, Prague 6, Czech Republic
| | - David Dunlop
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Flemingovo náměstí 542/2, 162 06, Prague 6, Czech Republic
| | - Jiří Czernek
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic
| | - Luděk Šefc
- Center for Advanced Preclinical Imaging (CAPI), First Faculty of Medicine, Charles University, Salmovská 3, 120 00, Prague 2, Czech Republic
| | - Jiří Beneš
- Institute of Biophysics and Informatics, First Faculty of Medicine, Charles University, Salmovská 1, 120 00, Prague 2, Czech Republic
| | - Petr Štěpánek
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic
| | - Pavel Hobza
- Institute of Organic Chemistry and Biochemistry, Czech Academy of Sciences, Flemingovo náměstí 542/2, 162 06, Prague 6, Czech Republic
| | - Martin Hrubý
- Institute of Macromolecular Chemistry, Czech Academy of Sciences, Heyrovského náměstí 2, 162 06, Prague 6, Czech Republic
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Abstract
Haemochromatosis is defined as systemic iron overload of genetic origin, caused by a reduction in the concentration of the iron regulatory hormone hepcidin, or a reduction in hepcidin-ferroportin binding. Hepcidin regulates the activity of ferroportin, which is the only identified cellular iron exporter. The most common form of haemochromatosis is due to homozygous mutations (specifically, the C282Y mutation) in HFE, which encodes hereditary haemochromatosis protein. Non-HFE forms of haemochromatosis due to mutations in HAMP, HJV or TFR2 are much rarer. Mutations in SLC40A1 (also known as FPN1; encoding ferroportin) that prevent hepcidin-ferroportin binding also cause haemochromatosis. Cellular iron excess in HFE and non-HFE forms of haemochromatosis is caused by increased concentrations of plasma iron, which can lead to the accumulation of iron in parenchymal cells, particularly hepatocytes, pancreatic cells and cardiomyocytes. Diagnosis is noninvasive and includes clinical examination, assessment of plasma iron parameters, imaging and genetic testing. The mainstay therapy is phlebotomy, although iron chelation can be used in some patients. Hepcidin supplementation might be an innovative future approach.
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Affiliation(s)
- Pierre Brissot
- INSERM, Univ. Rennes, INRA, Institut NUMECAN (Nutrition Metabolisms and Cancer) UMR_A 1341, UMR_S 1241, F-35000 Rennes, France
| | - Antonello Pietrangelo
- Division of Internal Medicine 2 and Center for Haemochromatosis, University Hospital of Modena, Modena, Italy
| | - Paul C. Adams
- Department of Medicine, University of Western Ontario, London, Ontario, Canada
| | - Barbara de Graaff
- Menzies Institute for Medical Research, University of Tasmania, Tasmania, Australia
| | | | - Olivier Loréal
- INSERM, Univ. Rennes, INRA, Institut NUMECAN (Nutrition Metabolisms and Cancer) UMR_A 1341, UMR_S 1241, F-35000 Rennes, France
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